Private Pay or Out-of-Pocket Pay
What is Out-of-Pocket / Private Pay ?
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At HFT, you have the option to pay out of pocket for services. Paying out-of-pocket for therapy is the most common option with therapists and therapy organizations that do not directly work with insurance companies.
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In the case of private pay, clients pay the full session fee at the time of services.
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A Good Faith Estimate will be provided, which is an estimate of the expected cost of services and is required when clients are not using insurance.
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HFT provides all clients with monthly statements and service summaries for client’s personal and tax records.
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Therapy services are tax deductible under medical expenses (though it is recommended that you consult with a tax professional to understand your unique circumstances regarding deductions).
Benefits of Private Pay:
There are many benefits to choosing to pay for therapy out-of-pocket. Some clients choose this option even with insurance benefits and coverage. Read more below to learn about the many benefits of private pay.
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Client Privacy
One benefit of private pay is privacy, since no third parties are involved in your care and will not have cause to access to your HFT client file.
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No Required Diagnosis
To submit claims to insurance providers, therapists must give clients a diagnosis and document medical necessity for therapeutic services to continue. Some clients do not want a diagnosis on their permanent medical record.​
Other clients may want to seek out therapy for a reason unrelated to a mental health diagnosis that is not covered by insurance, such as personal growth and development.
Additionally, some clients may wish to continue therapy services beyond the point when showing medical necessity would be possible.
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Greater Client Choice over which Therapist to Work With
When using private pay, clients can choose which therapist they would like to work with, rather than which therapist accepts their insurance plan.
This can open opportunities to find a therapist that feels like a good fit, or a more specific specialization, or particular type of therapy.
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Client Autonomy Over Therapy Process
Another benefit of private pay is complete client autonomy over the therapeutic process since, again, there is no involvement of the third-party interest (i.e. the insurance company). In private pay, the client and therapist decide on session frequency, length of therapy services, and what is most important to focus on.
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Sometimes Faster and More Flexible Access
When paying out of pocket for therapy, there is no need for clients to wait to hear back from their insurance provider for authorization or approval. ​
This can sometimes mean that clients can start therapy sooner or schedule more regularly without the added step.
Drawbacks to Private Pay / Out-of-Pocket Pay
Cost
The downside to private pay is the greater upfront cost to the client. Sometimes out-of-pocket pay is just not financially feasible. Another challenge related to the higher upfront cost can be that clients seek out less frequent services even if they would benefit from more regular therapy.
